Background Cervical cancer is a major public health problem. In 2018, globally 569,847 cervical cancer were diagnosed and 311,000 deaths were projected due to this preventable disease. Worldwide, therefore, the cervical cancer disease ranks as the fourth most frequently diagnosed cancer and the fourth leading cause of cancer death in women in 2018. The high rate of dysplasia in Senegal and the absence of well-organized screening programs informed this study, which aims to determine the prevalence of cervical dysplasia and its relationship to biological and socio-demographic characteristics. Methods This study is based on 1000 conventional smears collected during routine cervical cancer screening at the Gaspard Camara Health Center and the Histology - Embryology and Cytogenetics Laboratory of the Cheikh Anta DIOP University in Dakar. The smears were read according to the Bethesda and Richart systems. However, all data were returned to the Bethesda system using the correspondence table between the different classifications of squamous cell lesions of the cervix. Some of the patients with abnormal smears had colposcopy and if necessary a biopsy. Other patients with low-grade lesions were recommended to have their smears resumed in 6 months or 1 year later. Results Cytological analysis was performed for 1000 patients aged 16 to 82 years (mean age = 41 ± 11.16). Among these, 176 patients had abnormal smears, 23 had Atypical Squamous Cells of Undetermined Significance (ASCUS), 143 had a low-grade lesion, 9 had a high-grade lesion and 1 had carcinoma. Among the remaining 822 patients, cytological analysis revealed no suspected malignant lesions, but 623 among them had dystrophy and 2 were unsatisfactory. Among patients with abnormal smears, 104 patients (23 ASCUS + 71 low grade + 9 high grade + 1 carcinoma) had performed colposcopy, 40 of whom had normal colposcopy and 64 had abnormalities. Sixty-four (64) biopsies were performed. Four (4) were not satisfactory. However, for 26/60 biopsies, the histology was normal, 21/60 had a low grade, 11 displayed a high grade and only 2 had carcinoma. Among the 176 patients with abnormal smears, 72 low-grade patients had undergone cytological examination 6 months to 1 year later to determine the persistence, regression or progression of low-grade dysplasia. During follow-up, persistence was observed in 25% ( n = 18) of cases, progression to High-grade squamous intraepithelial lesion (HSIL) was detected in 2.78% ( n = 2), while 72.22% ( n = 52) of the patients experienced regression. Conclusion In this study, the prevalence of abnormal smear was 17.60% for cytology. Meanwhile, the Colposcopy and histology confirmed just 3.40%. These results underline the interest and need for a review of the discrepancies observed between pathologists.

中文翻译：

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达喀尔地区宫颈癌的系统筛查：患病率及其与生物学和社会人口学参数的相关性

背景 宫颈癌是一个重大的公共卫生问题。2018 年，全球有 569,847 人被诊断出宫颈癌，预计将有 311,000 人死于这种可预防的疾病。因此，在全球范围内，宫颈癌是 2018 年第四大最常被诊断出的癌症，也是女性癌症死亡的第四大原因。塞内加尔不典型增生的高发病率和缺乏组织良好的筛查计划为这项研究提供了依据，其中旨在确定宫颈发育不良的患病率及其与生物学和社会人口学特征的关系。方法 本研究基于在 Gaspard Camara 健康中心和达喀尔 Cheikh Anta DIOP 大学的组织学-胚胎学和细胞遗传学实验室常规宫颈癌筛查期间收集的 1000 份常规涂片。根据 Bethesda 和 Richart 系统读取涂片。但是，所有数据都使用宫颈鳞状细胞病变不同分类之间的对应表返回到Bethesda系统。一些涂片异常的患者进行了阴道镜检查，必要时进行活检。其他低级别病变患者建议在 6 个月或 1 年后恢复涂片检查。结果 对 1000 名 16 至 82 岁的患者（平均年龄 = 41 ± 11.16）进行了细胞学分析。其中，涂片异常176例，意义未明非典型鳞状细胞（ASCUS）23例，低级别143例，高级别9例，癌1例。在其余 822 名患者中，细胞学分析未发现疑似恶性病变，但其中623人有营养不良，2人不满意。在涂片异常的患者中，104例（23例ASCUS+71例低级别+9例高级别+1例癌）进行了阴道镜检查，其中阴道镜检查正常40例，异常64例。进行了六十四 (64) 次活检。四 (4) 次不满意。然而，对于 26/60 活检，组织学正常，21/60 为低级别，11 例为高级别，只有 2 例为癌。在 176 例涂片异常患者中，72 例低级别患者在 6 个月至 1 年后进行了细胞学检查，以确定低级别不典型增生的持续、消退或进展。随访期间，25% (n = 18) 的病例持续存在，2.78% (n = 2) 进展为高度鳞状上皮内病变 (HSIL)，而 72. 22% (n = 52) 的患者出现消退。结论 本研究中细胞学涂片异常的发生率为17.60%。同时，阴道镜和组织学证实只有 3.40%。这些结果强调了审查病理学家之间观察到的差异的兴趣和必要性。